Pet's Name *

Owner's Name *

First

Last

Phone Number *

Email *

Emergency Contact - Name & Phone: This contact is authorized to make medical and care decisions for my pet in my absence. I realize I am financially responsible for the cost of care given to my pet while boarded. *

Drop Off Date: (Please fill out this form after you have a confirmed reservation to board your pet) *

Pick Up Date *

Estimated Pickup Time *

NOTE: Our hours are 7 AM-6 PM Mon-Fri, 8 AM-1 PM Sat, and Closed on Sun.

Pets picked up by 11:00 a.m. on departure day, will not be charged for that day.

PLEASE NOTE: During holidays and Spring & Fall School Breaks, we require a deposit of $47.00 (one-night boarding) for a boarding reservation. Please give a minimum of 24 hours when changing or canceling your reservation, less than 24 hours' notice will result in forfeiting the deposit.

We do not recommend leaving personal items for your pet and are not responsible for them. Please list any items you choose to leave.

Food options while boarding *

House food (Blue Buffalo GI Adult Dog Food)
Your Own Food (Name of food and feeding instructions)

Feeding Instructions

Will your pet need to receive medications while boarding (additional $6.50/day for oral or topical meds and an additional $43.70 per day for injectable meds/after hour nursing care)? (Prescription medications need to be in original prescription bottle labeled with name of patient, name of drug, quantity, and frequency of medication). NOTE: Any medication must be in original Rx bottle and identified to ensure proper dosing and to prevent under and/or over dosing of medication. Please do not place medication in food to be dispensed with food. *

Yes
No

If Yes Please List *

Would you like for your pet to receive a bath? (Select below) *

Yes, I want my pet to have a bath by kennel staff for additional fees.
Yes, I want my pet to have a Free bath by kennel staff AFTER 5 DAYS OF BOARDING.
No. I do not want my pet to receive a bath.

Would you like for your pet to receive daily doctor checkups (additional $16.00)? This is for pets that have advanced medical needs and may need additional services. *

Yes. I understand I will be charged an additional $16 a day.
No

Is there anything else you would like to relay to the staff about your pet?

In order to board, your pet must be current on vaccinations and fecal exam. This protects your pet from diseases that are easily transmitted. Required vaccinations: DOGS - Canine Influenza (including booster), Rabies, DA2PPv - within the last 12 months. Bordetella and negative fecal test within the last 6 months. CATS - Rabies, FVRCPC, negative fecal test within the past 12 months. If your pet is not current the required vaccinations/fecal test will be administered at arrival. Please note that any vaccine administered will also require an exam with an exam fee. *

Yes. I authorize the staff to administer required vaccinations at an additional cost.
No. My pet is current on vaccinations.

Please list where the vaccinations were given *

If you have a copy of your vaccinations, you can also upload them to us now.

Click or drag a file to this area to upload.

ATTENTION (Please read and sign below. Your signature acknowledges you agree to these terms):

If my pet was to become ill while boarding and the staff are unable to contact me by the numbers listed above, I authorize Animal Care Center of Carters Creek to perform necessary treatments for the health, safety, or well being of my pet while under their care. I understand that this will be at my expense and that payment will be due at the time of discharge.

If my pet should injure itself in any escape attempt, refuse food, become ill, or become deceased while in their care, I will not hold the doctors, staff, or Animal Care Center of Carters Creek to be responsible or liable, except in the presence of gross negligence.

If I neglect to pick up my pet by the end of my contracted agreement and/or do not provide any written or verbal extension of the agreement, after 10 days from the agreed pick up date, Animal Care Center of Carters Creek may assume that the pet has been abandoned and will become property of Animal Care Center of Carters Creek to be rehomed, turn over to a rescue/humane society, or in special cases euthanize. I understand that abandonment does not release me of my obligation for full payment of the bill.

I authorize Animal Care Center of Carters Creek to use my pet's photo in professional social media and advertising.

If my pet is found to have fleas/ticks or intestinal parasites while boarding, I authorize Animal Care Center of Carters Creek to provide appropriate treatment at additional cost.

Signature *

Clear Signature

Date completed *

Boarding Admission Form

Boarding Admission Form

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